The Link Between Blood Sugar and Overweight

Many people are surprised to learn that prediabetes (also known as impaired fasting glucose, impaired glucose tolerance, insulin resistance, metabolic syndrome, or syndrome X) is a common underpinning of weight problems. Here’s why.

When we eat “fast” carbohydrates (i.e., refined sugars, flour products such as breads, bagels, muffins, pastas, etc.), they are rapidly digested and quickly spike blood-sugar levels. In response, the body releases a surge of insulin, a hormone that lowers blood sugar levels. In the early stages of prediabetes, this excess insulin often brings blood sugar levels down to below where they originally were. Low blood sugar in turn makes people hungry, so they reach for another quick fix—usually some sort of sugary food. This raises blood sugar, causing another surge of insulin, and so the blood sugar and insulin rollercoaster continues. After years of eating fast carbs, the body starts to become “insulin resistant”: cells lose their ability to respond to insulin and thus manage blood sugar. As a result, blood-sugar levels start to climb—a clear sign of prediabetes.

For many people this process begins with those first 10 extra pounds, according to a recent study. German researchers found that with such a modest gain in weight, insulin levels remained elevated, a sign of insulin resistance and prediabetes. Because insulin also regulates fat storage, particularly around the belly, high levels of the hormone further increase fat accumulation, creating a vicious cycle. Dietitians often try to scare people with prediabetes or diabetes into action with warnings of such complications as amputation, eye disease, and kidney failure. But the health threats posed by overweight and prediabetes are actually far greater. These conditions are “ground zero” in an expanding shock wave of chronic health problems. They increase the risk of coronary heart disease, cancer, and Alzheimer’s disease, and they promote inflammation, an underpinning of every disease process.

Bad and Good Eating Habits

Overweight, prediabetes, and type-2 diabetes are nutritional diseases, and they are best treated nutritionally. They are caused by what I call the “too many, too much syndrome,” in which people consume excessive amounts of calories, sugary foods, sugar-like processed carbohydrates (usually grain flours), trans fats, and junk oils (such as soybean oil).

The average American now consumes 3,900 calories daily—two times what the average sedentary man and almost three times what the average woman requires. In addition, trans fats increase insulin resistance as well as the accumulation of belly fat. It’s not just a matter of calories and carbohydrates either. These unhealthy foods also turn on genes involved in inflammation and other health problems.

To reverse both prediabetes and weight problems, it helps to emphasize two food groups: high-fiber vegetables and quality protein. High-fiber veggies (salads and steamed vegetables) provide “slow” carbs, which gently raise blood sugar levels and help keep them stable, thus avoiding insulin surges. Similarly, quality protein (such as fish and chicken) stabilizes and gently lowers blood sugar. Together, protein and veggies avoid the extreme blood sugar peaks and valleys caused by fast carbs, and in the process they also dampen hunger and food cravings.

Helpful Supplements

Nutrients form the building blocks of our biochemistry, and many have specific beneficial roles in regulating insulin function and blood sugar levels. These supplements can enhance the benefits of better eating habits. As insulin and blood sugar levels improve, appetite and hunger will decrease—leading to the consumption of fewer calories and low-quality carbohydrates, which will then be followed by weight loss. While many supplements claim to prevent or reverse blood-sugar problems, few are supported by studies on humans (rather than mice or cells). Some of the nutrients proven to aid blood-sugar control in humans are discussed below. These nutrients can be found combined in well-formulated products or individually as single-ingredient products. Note: The dosages listed below are for taking the supplements individually. When combining nutrients, dosages can usually be reduced because of synergistic effects.

• Chromium - Researchers have known for 40 years that chromium is required for the normal function of insulin, and some studies have even found that chromium deficiency can sometimes result in diabetes. The two leading forms of supplemental chromium are chromium picolinate and chromium polynicotinate chromium (also called niacin-bound chromium). Both forms appear to be equivalent in benefits. In one study, people taking chromium picolinate had substantial reductions in blood sugar and insulin levels. In a separate study people taking chromium polynicotinate lost more fat while preserving muscle. Try 500 mcg twice daily, or less if chromium is combined with other nutrients.
• Biotin - This B vitamin regulates genes that play roles in normal glucose tolerance, and it appears to have insulin-like effects. People with diabetes and other forms of glucose tolerance are often deficient in biotin. Large amounts of biotin can significantly reduce triglyceride levels, a risk factor for both diabetes and heart disease. Biotin can improve blood sugar on its own, but it seems most effective when combined with chromium. In a recent study, a combination of chromium picolinate and biotin led to about a 10 percent reduction in blood-sugar levels. Biotin is extraordinarily safe at large doses, so consider taking 1,000 to 5,000 mcg (1 to 5 mg) daily.
• Alpha-lipoic acid - Researchers at the University of Pennsylvania discovered in 1970 that alpha-lipoic acid increased the burning of blood sugar. Since then, German researchers and physicians have led the way in using alpha-lipoic acid to treat diabetic neuropathy—the nerve pain or numbness that is frequently a complication of diabetes. Alpha-lipoic acid is an antioxidant as well as a cofactor in what biochemists call the Krebs cycle—the biochemical process that breaks down food molecules for energy. Although it has been shown to lower blood sugar levels, alpha-lipoic acid seems to have more of an effect on improving insulin sensitivity. (Improved insulin sensitivity is good—a sign that the body needs less insulin to manage blood sugar levels.) Take 100-200 mg of alpha-lipoic acid before each meal.
• Silymarin - Of all the herbal supplements recommended for improving blood-sugar problems and diabetes, silymarin has the strongest scientific support from human studies. Silymarin is the antioxidant extract of the herb milk thistle (Silybum marianum). It has long been recommended for improving liver function, and therein lies its benefits in glucose tolerance: the liver works in tandem with the pancreas to regulate insulin and blood sugar. Three clinical trials have documented silymarin’s benefits. In these studies, patients have benefited from lower blood sugar and insulin levels, less sugar in the urine, and lower HbA1c levels. Patients in the studies took 200 mg of silymarin three times daily, but lower dosages can be used in conjunction with other supplements.
• Vitamin D - Recent studies have shown that vitamin D reduces the risk of cancer, heart disease, and osteoporosis. It also plays roles—along with calcium—in regulating insulin and blood sugar. Vitamin D deficiencies in the United States affect 40 to 80 percent of the population, and deficiencies are exacerbated during the winter months, when people are exposed to less sunlight.

People who are overweight or have diabetes are especially susceptible to vitamin D deficiency. In a large study, almost two of every three people with diabetes were deficient in vitamin D. Anastassios G. Pittas, MD, of the Tufts-New England Medical Center, has pointed out that vitamin D is sequestered in fat cells, away from other tissues that need it.

A three-year study by Pittas found that people taking 700 IU of vitamin D and 500 mg of calcium had negligible increases in blood sugar, while those taking placebos had substantial increases in blood sugar over the three years. Another study found that women who took supplements containing 800 IU of vitamin D and 1,200 mg of calcium daily had a 33 percent lower risk of developing diabetes over 20 years. Try 1,000 to 2,000 IU of vitamin D plus 500 mg of calcium citrate.

• Vitamin K -Vitamin K is needed for the synthesis of osteocalcin, long recognized as a bone-matrix protein. In 2007, researchers reported in the journal Cell that osteocalcin also functions as a hormone that regulates insulin, glucose, and the size of fat cells. Although that study relied on laboratory animals, it has stimulated new research on vitamin K, osteocalcin, and glucose tolerance. Vitamin K2 is the most active form of the vitamin; take 1,000 to 5,000 mcg daily. Caution: If you take anticoagulant drugs (such as Coumadin), check with your doctor before taking vitamin K.

• Omega-3 fish oils - The omega-3s, a family of healthy oils, improve glucose tolerance, and a recent study published in the American Journal of Clinical Nutrition found that large supplemental amounts may help burn body fat. Docosahexaenoic acid (DHA), one of the key omega-3 fats in fish oil, blocks the formation of fat cells while promoting the breakdown of existing fat cells. Try 1,000 to 3,000 mg daily of omega-3 fish oils or 500 to 1,000 mg daily of DHA.
• Pycnogenol® - This natural antioxidant complex blocks the activity of alpha-glucosidase, a carb-digesting enzyme. Recent studies have found that supplemental Pycnogenol can lower fasting blood sugar by about 5 percent and postprandial blood sugar by about 10 percent. Try 100-200 mg daily.
• American Ginseng - Several studies have found that American ginseng (Panax ginseng) can lower blood sugar levels, at least in the short term. Studies conducted at the University of Toronto found that 3 or more grams of American ginseng reduced the anticipated rise in blood sugar by 30 to 38 percent after a glucose tolerance test.
• Fiber supplements - Fiber is one of nature’s best starch blockers and blood-sugar regulators. Many plant-derived fiber supplements are sold, but PolyGlycopleX™, or PGX, is supported by good scientific evidence. It’s available in capsules or granules; the latter should be mixed in a glass of water before eating.

Last But Not Least

People who are overweight or who have prediabetes or diabetes are likely to experience multiple nutrient deficiencies because of a history of poor eating habits or the sequestering of fat-soluble vitamins in fat cells. Such individuals might want to consider taking a high-potency multivitamin supplement in conjunction with higher levels of other nutrients.

A multivitamin complements good eating habits and provides a sound foundation for other supplements. For example, vitamins B1, B2, and B3 are involved in the metabolism of carbohydrates. Vitamin B1 levels are particularly sensitive to carbohydrate intake, and large amounts of carbs reduce B1 levels. In addition, people with diabetes are commonly deficient in vitamin B1. In 2006, researchers reported in the Archives of Internal Medicine that people taking high doses of metformin, or taking the drug for more than a couple of years were more than twice as likely to suffer from vitamin B12 deficiency.

When I coach people on eating habits and supplements, I consistently find that hunger and overeating are intertwined with blood-sugar issues such as prediabetes. When the blood sugar problems are addressed, hunger decreases and people start to lose weight. The benefits increase when people combine supplements with better food choices, moderate physical activity, and management of stress.

References Available Upon Request